Colonoscopy attachments for the detection of precancerous lesions during colonoscopy: A review of the literature

Table 2 Meta-analyses evaluating the effect of accessories on colonoscopy outcomes

Author (yr)	Device vs comparator	Included Studies (n)	Included studies’ design	Patients (n)	ADR	PDR	MAC	CIR	CIT
Westwood 2012	CAC vs CC	12 (9 FP, 3 AB)	RCTs	6185	NR	aOR (95%CI): 1.13 (1.02-1.26)	NR	aOR (95%CI): 1.36 (1.06-1.74)	MD (95%CI): 0.04 (-0.03 to 0.12) min
Ng 2012	CAC vs CC	16 (13 FP, 3 AB)	RCTs	8991	RR (95%CI): 1.04 (0.90-1.19)	aRR (95%CI): 1.08 (1.00-1.17)	NR	RR (95%CI): 1.00 (0.90-1.02)	aMD (95%CI): -0.64 (-1.19 to -0.10) min
He 2012	CAC vs CC	19 (14 FP, 5 AB)	RCTs	9235	NR	aOR (95%CI): 1.12 (1.02-1.22)	NR	aOR (95%CI): 1.36 (1.13-1.64)	aMD (95%CI): -0.65 (-0.85 to −0.44) min
Omata 2014	CAC vs CC	10 (10 FP)	RCTs	5219	RR (95%CI): 1.07 (0.94-1.23)	RR (95%CI): 1.00 (0.86-1.16)	NR	NR	NR
Desai 2017	CAC vs CC	4 (4 FP)	2 RCTs; 2 retrospective	5093	a1OR (95%CI): 1.49 (1.08-2.05)	NR	NR	NR	NR
Mir 2017	CAC vs CC	23 (18 FP, 5 AB)	RCTs	12947	OR (95%CI): 1.11 (0.95-1.30)	aOR (95%CI): 1.17 (1.06-1.29)	NR	OR (95%CI): 1.32 (0.94-1.87)	aMD (95%CI): -0.82 (-1.20 to -0.44) min
Chin 2016	2EAC vs CC	9 (4FP, 5 AB)	4 RCTs; 1 prospective observational; 4 retrospective	5624	aOR (95%CI): 1.49 (1.23-1.80)	NR	NR	OR (95%CI): 1.26 (0.70-2.27)	NR
Williet 2018	2EAC vs CC	12 (7 FP, 5 AB)	RCTs	8376	aRR (95%CI): 1.20 (1.06-1.36)	aRR (95%CI): 1.20 (1.06-1.36)	MD (95%CI): 0.11 (-0.17-0.38)	RR (95%CI): 0.99 (0.97- 1.00)	MD (95%CI): -0.57 (-1.43 to 0.28) min
3Facciorusso 2017	CAC vs CC	14 (14 FP)	RCTs	8306	RR (95%CI): 1.07 (0.96-1.19)	RR (95%CI): 1.08 (0.99-1.18)	NR	RR (95%CI): 1.00 (1.00- 1.01)	aMD (95%CI): -0.68 (-1.11 to -0.24) min
	2EAC vs CC	9 (4FP, 5 AB)	RCTs	7072	aRR (95%CI): 1.21 (1.03-1.41)	aRR (95%CI): 1.22 (1.07-1.40)	NR	RR (95%CI): 1.00 (0.98- 1.01)	aMD (95%CI): -0.93 (-1.55 to -0.30) min
	Endorings vs CC	1 (1 FP)	RCTs	116	RR (95%CI): 1.70 (0.86-3.36)	RR (95%CI): 1.68 (0.94-2.99)	NR	NR	MD (95%CI): 0.90 (-1.47 to 3.27) min

¹refers to right colon ADR;

²refers to both first generation Endocuff and Endocuff Vision;

³network meta-analysis.

^aStatistical significant. ADR: Adenoma detection rate; AMR: Adenoma miss rate; PDR: Polyp detection rate; MAC: Mean adenomas detected per colonoscopy; CIR: Cecal intubation rate; CIT: Cecal intubation time; CAC: Cap-assisted colonoscopy; CC: Conventional colonoscopy; EAC: Endocuff-assisted colonoscopy; FP: Full paper; AB: Abstract; RCT: Randomized controlled trial; NR: Not reported; OR: Odds ratio; 95%CI: 95% confidence intervals; RR: Relative risk; MD: Mean difference.